Updated: Feb 10
January is Cervical Cancer Awareness month. Cervical cancer is diagnosed in as many as 570,000 women globally each year. Around 311,000 of those women die from the disease. At Fertility4Me, we highlight this not only because it impacts women’s health, but also because cervical cancer impacts fertility.
Here are some facts from the World Health Organization about cervical cancer:
Cervical cancer is the fourth most common kind of cancer for women
Early intervention is vital to treating cervical cancer
Two types of HPV (human papillomavirus) are the cause of more than 70% of cervical cancer
There are vaccinations that may provide immunity to HPV
If you are trying to get pregnant after being treated for cervical cancer, you may encounter issues. It’s important to understand the dynamics at work. Read on to learn about how cervical cancer can impact your fertility and what treatment options may be available to you.
Cervical Cancer and Fertility Sparing
Cervical cancer frequently occurs during a woman’s reproductive years. Also called uterine cervix, cervical cancer impacts over 11,000 women in the U.S. each year. Reproductive endocrinologists (REIs) and gynecological oncologists are probably the best doctors to assist you if you are trying to conceive after cervical cancer.
Fertility sparing is a process in which a woman makes decisions about cancer treatment for the sake of future childbearing. An example of this is freezing eggs or choosing a treatment course that preserves the uterus. This may be possible during the early stages of cervical cancer.
Note: if you want more info on this, a great resource is the Alliance for Fertility Preservation.
Typical cervical cancer treatment options include:
Hysterectomies and radiation treatments permanently affect the ability to get pregnant. For certain women, less aggressive treatment options are available that may allow pregnancy after recovery.
If you want to get pregnant but may have cervical cancer, both the diagnostic and treatment measures you undergo should be chosen with care. Measures that may increase your chances of retaining fertility include:
Radical trachelectomy (VRT)
There are no guarantees, but these three treatment options have been backed by research. One of them may be an option for you.
Conization to Spare Fertility
When growths due to cervical cancer are limited to the cervix, conization may be a choice. According to the NYU Langone Fertility Center, this process removes a cone-shaped portion of the tissue from the patient’s cervix. This may be done surgically in an outpatient center.
Simple Trachelectomy Cervical Cancer Treatment
Early stage cervical cancer may also be treated using a simple trachelectomy. According to the Journal of Gynecologic Oncology, this method along with a lymph node evaluation could safely preserve fertility while being an effective treatment for some patients. This procedure removes only a portion of the cervix, leaving the hysterectomy intact. In another study published in the International Journal of Gynecological Cancer Treatment, 81% of patients had no recurring cancer and 50% had conceived.
Radical Trachelectomy for Fertility Sparing
Radical trachelectomy is a last effort to leave the hysterectomy intact. Also called a radical cervicectomy, this surgery removes the cervix as well as the top of the vagina and tissue surrounding. Lymph nodes in the pelvis are also taken out to confirm that the cancer is localized.
A retrospective analysis was done of a 2009 test of women who had an abdominal radical trachelectomy. There were 61 women in the original test. As of 2019, more than 13% of those women had successfully conceived. Another published study has shown as high as a 99%, five-year survival rate for patients treated with VRT, with an 85% fertility retention rate.
How Can You Support Cervical Cancer Research?
While fertility sparing options are increasing both in public and medical circles, these treatments are still not entirely mainstream. Every person has the opportunity to advocate for positive fertility outcomes for women who are treated for cervical cancer. In addition to supporting HPV prevention and research, the National Cervical Cancer Coalition highlights new initiatives and has local chapters nationwide. Visit their website to learn more.
Want to learn more about fertility in general? Anyone who supports women’s health should have a good understanding of fertility. Whether you are trying to conceive, pregnant, undergoing fertility treatments or are simply pursuing a healthy lifestyle, we have great resources available for you.
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Halaska, Robova et al. “The role of trachelectomy in cervical cancer.” Encancermedicalscience, ecancer Global Foundation, 2015. Accessed January 27, 2020.
Nishio, H et al. “Abdominal radical trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer in a series of 61 women.” Gynecology Oncology, October 2009. Accessed January 27, 2020.
NYU Langone Health. “Fertility-Sparing Options for Cervical Cancer.” Perlmutter Cancer Center, N.D. Accessed January 27, 2020.
Plante, Marie. “Patient education: Fertility preservation in women with early-stage cervical cancer (Beyond the Basics).” Uptodate.com, updated June 13, 2019. Accessed January 27, 2020.
Ramirez, Pedro T. et al. “Management of low-risk early-stage cervical cancer: Should conization, simple trachelectomy, or simple hysterectomy replace radical surgery as the new standard of care?” Gynecology Oncology, January 2014. Accessed January 27, 2020.